Tozzi

Excessive exercise (EE) is common among eating disorder patients. Indeed, in the study I’ll write about today, 39% of patients engaged in EE. Previous studies have tried to find psychopathological and personality correlates of EE but the results have been inconsistent. Some studies have suggested that impulsivity and addictiveness are highly correlated with EE whereas others found that anxious and depressive traits were more closely associated.

In a retrospective case series study involving outpatients with AN and BN, Penas-Lledo et al. found higher levels of anxiety and depression… among those who were identified as exercising excessively. The authors claimed that exercise might serve to reduce anxiety and stress in individuals with AN. In a similar study with adolescent inpatients with AN, Holtkamp et al. found that anxiety significantly predicted variance in exercise levels. These investigators proposed that anxiety symptoms in combination with food restriction contributed to increased levels

Anonymous asked, “I’ve never lost my period. Weight restored I am naturally thin, but even at a BMI of 15 or so I always got my period (although it wasn’t always regularly). This makes me feel like I’m not actually sick because I hear about everyone losing their period.”

eatruncats replied: “To the anon who asked about losing periods: For all the times she worries about not being sick enough because she never lost her period, there are people who lost their periods at BMIs of 18, 19, and 20 who worry about not being sick enough because they never got to a BMI of 15. If you have an eating disorder, you are “sick enough.” Period.“

As it stands now, amenorrhea–or the loss of three consecutive menstrual cycles–is a diagnostic criterion for anorexia nervosa. Individuals who have not lost their periods are diagnosed with eating disorder … Continue reading →

Symptom fluctuation and diagnostic crossover are common in eating disorder patients. A study by Eddy et al.(2008) – who followed patients over an average of 7 years – showed that crossover between subtypes and full-syndrome diagnoses is very common : of those initially diagnosed with anorexia nervosa, almost 73% crossed over to another diagnosis (between symptoms and to bulimia nervosa). More specifically, roughly 50% experienced fluctuation between subtypes (restricting, AN-R, and binge/purge type, AN-BP) and roughly 35% crossed over to bulimia nervosa (a subset experienced both). Of those initially diagnosed with bulimia, roughly 14% crossed over to AN-BP and of those, 3.91% crossed over to AN-R.

This finding (though, well-known to ED specialists and even more well-known to patients) has important implications for treatment. For example, CBT and anti-depressants seem to have positive results in bulimic patients, but not so much in anorexics. What then, about those that crossover … Continue reading →

Definitioner

the amount of hostility and criticism directed from other people to the patient, usually within a family (14)

affect

in psychology, behavior that expresses a subjectively experienced feeling state (emotion); affect is responsive to changing emotional states (14)

outcome

in a research study, a component of a participant's clinical and functional status after an intervention has been applied, that is used to assess the effectiveness of an intervention (2)

traits

characteristic behaviors and feelings that are consistent and long lasting (5)

trait (traits)

characteristic behaviors and feelings that are consistent and long lasting (5)

recall bias

a bias arising from mistakes in recollecting events, both because of failures of memory, and looking at things 'with hindsight' and possibly changed views; people's reports of what is happening to them currently, therefore, can be more accurate than their recall of what happened two years ago and how they felt about it at the time; this bias is a threat to the validity of retrospective studies (2)

bias

in statistics, a systematic error or deviation in results or inferences from the truth; in studies of the effects of health care, the main types of bias arise from systematic differences in the groups that are compared (selection bias), the care that is provided, exposure to other factors apart from the intervention of interest (performance bias), withdrawals or exclusions of people entered into a study (attrition bias) or how outcomes are assessed (detection bias); reviews of studies may also be particularly affected by reporting bias, where a biased subset of all the relevant data is available (2)

temperament

innate personality features or dispositions (5)

SD (standard deviation)

the average distance of values from the mean; indicates approximately how far on the average scores differ from the mean; unevenly distributed values will give a higher standard deviation than those fairly evenly distributed around the mean; the lower the standard deviation, the more typical is the mean (6,7)